Please indicate names of owners or officers
Owner's/Officer's Information 1
Owner's/Officer's Information 2
Major Supplier #1
Major Supplier #2
Major Supplier #3
Bank Reference #1
Bank Reference #2
PLEASE READ AND SIGN THE FOLLOWING STATEMENT AFTER YOU HAVE COMPLETED APPLICABLE SECTIONS
You are authorized to contact parties indicated on this application for verification. For purposes of obtaining credit, I/We certify that the information given in this application is true and accurate, and any
financial information submitted correctly reflects our financial condition. I/We agree to pay all invoices within stated terms and to pay services charges on amounts paid after invoice due dates at a rate of
1.5% per month, or the maximum allowable rate, whichever is less. In event suit is instituted to collect amounts owing to you and a judgment is rendered in your favor, I/We agree to pay court costs and
reasonable attorney fees. I/We have read this agreement and a copy has been made available to us or is available to us upon our requesting same from the credit department.
PERSONAL GUARANTEE – PLEASE DO NOT INCLUDE TITLE WHEN SIGNING PERSONAL GUARANTEE
For value received, including merchandise, services, or other valuable consideration, I hereby unconditionally guarantee at all times, full and prompt payment, upon demand, of any indebtedness which
has been incurred under this agreement. I understand this to mean that I will personally guarantee payment of all debts and obligations under this agreement.